Payer ID
SMPLY
Alpha ID SMPLY on Claim.MD; legacy numeric IDs (00199, 27094) seen and vary by clearinghouse — verify.
Timely Filing Limit (TFL)
~90 days from DOS for full payment, with a 50% reduction for claims filed 3–6 months out — verify against current FL Medicaid provider manual (which may state 180 days)
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse
Availity Essentials (mandated EDI gateway)
Provider Services
844-405-4296
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Varies — confirm via portal / clearinghouse
Provider Portal
https://provider.simplyhealthcareplans.com/florida-provider/home
Elevance/Anthem-owned. The 90-day-for-full-payment rule with a 50% reduction window is an outlier — verify. Absorbed former Vivida (Region 8) and Lighthouse (Regions 1-2) Medicaid members.
Values vary by plan, region, and contract and can change. Confirm in the payer portal or with your clearinghouse before filing.
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